Vaginismus
 AGE Can affect sexually active females of any age |  GENDER |
 LIFESTYLE |  GENETICS Not significant factors |
Vaginismus is a spasm of the muscles around the entrance to the vagina, making sexual intercourse painful or impossible.
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In vaginismus, the pelvic floor muscles go into painful involuntary spasm and reduce the size of the vaginal opening. As a result, sexual intercourse may be very painful and vaginal penetration can often be impossible. The condition varies in severity for different women. Some women are affected by vaginismus to such an extent that they cannot insert even a finger or a tampon into the vagina and may need an anaesthetic for a vaginal examination. Other women may be able to tolerate a vaginal examination by a doctor or nurse but cannot tolerate sexual intercourse.
What are the causes?
Vaginismus is usually psychological in origin and often occurs in women who fear that penetration may be painful. This fear may result from a previous traumatic sexual experience, such as a rape or sexual abuse in childhood. Another cause of vaginismus may be the fear of pregnancy. Anxiety or guilt concerning sex may also be a contributing factor to this condition.
Certain physical disorders can also lead to vaginismus. Inflammation of the vagina (see Vulvovaginitis) may make intercourse painful and lead to vaginismus. Some women develop the condition because they expect that sex will be painful after childbirth or that they will experience sexual difficulties during or after the menopause (see Menopausal problems).
What might be done?
Your doctor will examine you gently to look for any physical problem that could make penetration painful or difficult. If there is an underlying physical cause, he or she will treat it. If the problem is psychological, you may need some form of psychological therapy or, alternatively, you may be referred to a sex therapist (see Sex therapy). The sex therapist will explain that the vaginal wall is elastic and may teach you relaxation exercises. He or she may then show you how a small dilator can be inserted into the vagina. By practising this technique and gradually using larger dilators, you should lose your fear that penetration will be painful. Treatment for vaginismus is successful in about 9 out of 10 women.
TREATMENT: Sex therapy
Sex therapy is often helpful when a sexual problem has a psychological basis rather than a physical cause. The type of therapy used depends on your problem but often involves discussions with a sex therapist. To overcome particular problems, the therapist may set exercises for you to practise at home, either by yourself or with your partner.
Discussion sessions
Discussing sexual problems with a trained sex therapist or counsellor can often help a couple to analyse and understand their relationship and sexual needs more clearly. It is important that both partners attend the therapy sessions. Each visit lasts about 1 hour, and several sessions may be necessary.
Exercises
A sex therapist may assign you exercises to practise at home to improve the way in which you and your partner communicate. Exercises may include techniques such as sensate focus. This technique involves experiencing your partner simply through touch and is helpful for problems stemming from anxiety about performance.
BMA Complete Family Health Guide
Copyright © 2005 Dorling Kindersley
Posted 04.05.2011
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